Provider Demographics
NPI:1609845148
Name:FISHER, JOSEPH SAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SAUL
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1650 HUNTINGDON PIKE
Mailing Address - Street 2:SUITE 317
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046-8004
Mailing Address - Country:US
Mailing Address - Phone:215-947-5304
Mailing Address - Fax:215-947-3458
Practice Address - Street 1:1650 HUNTINGDON PIKE
Practice Address - Street 2:SUITE 317
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046-8004
Practice Address - Country:US
Practice Address - Phone:215-947-5304
Practice Address - Fax:215-947-3458
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012600E207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0045771000OtherKEYSTONE HEALTH PLAN EAST
PA0045771000OtherKEYSTONE HEALTH PLAN EAST
PA0658490000Medicare ID - Type Unspecified